Snapshots From the Days of Bare-Hands Anatomy

Tuesday

The array of familiar objects threatened by digital technology encompasses the old (books, paintings) and the new (CDs). And then there is the human body, which counts as both.

Not the bodies we use, of course, but rather the bodies we allow medical professionals to use while training, to familiarize themselves with the terrain. Dissecting a cadaver has been part of medical education for millenniums. But the cadaver that enters the gross anatomy suite with the blessing of both the prior owner and the state is actually quite a new phenomenon.

Barely a century ago American medical schools were helping themselves to alumni of the local poorhouse for some of their teaching material and paying grave robbers for the rest. Only with a 1968 federal act did a nationwide system of voluntary donation bring uniformity to the process.

Now the same technology that lets us scan living bodies in all dimensions may obviate our need for dead ones, as some anatomy courses move from real dissection to its virtual counterpart — clean and odor-free, in crystal-clear focus with infinite zoom.

Some say virtual anatomy can never replace the transcendent reality. Some say it is a huge improvement over smelly, greasy, inconvenient flesh. Both arguments will be fueled by “Dissection,” an extraordinary collection of photographs that makes even today’s flesh-and-blood anatomy laboratories look tame.

Photography soared in popularity after the Civil War, and in 1900 Eastman Kodak’s Brownie camera created armies of snapping amateurs. A vogue for photographing the gross anatomy class swept through American medical schools, as students were moved to recreate in black and white the iconic dissection scenes of Rembrandt and other great masters: scholarly doctors posing around the supine cadaver, scalpels in hand, gravitas on face.

Some student groups posed for professional photographers. Others took their own shots. The prints were mounted on living room walls, sent as postcards and even used as calling cards. By 1920 the craze had simmered down, and after World War II it was pretty much over.

But hundreds of these photographs endure. John Harley Warner, chairman of Yale’s History of Medicine program, and James M. Edmonson, curator of a museum of medical memorabilia at Case Western Reserve University in Cleveland, have culled more than 100 for what might under other circumstances be considered a coffee-table book. It is a striking, glossy, oversize volume, immensely decorative if shredded flesh and the odd bone are your idea of décor.

But as ghoulish as the cadavers in these shots may be — they range from pristine, untouched corpses to unrecognizable piles of picked-over remains — their shock value diminishes with each turned page. Conversely, the attention commanded by the groups of young students self-consciously posed around the dissecting table never wanes.

They attended schools all over the country, from prestigious Harvard and Johns Hopkins to small, short-lived institutions in the Midwest. Only a few female faces are scattered in the groups of white men: in one photograph a handwritten scrawl identifies one small girl as “wife.” A few shots depict all-female and all-black students from segregated schools.

The so-called dieners, who prepared the bodies and disposed of the remains, were almost all black men who stared impassively into the camera a little apart from the students.

Until well into the 20th century all of them wore street clothes. A few had skimpy aprons to deflect noxious splashes, but the disposable latex glove was far in the future: almost all worked with bare hands. That fact alone is enough to chill the 21st-century medical spine: we may shake our patients’ hands and touch their skin, but the tactile sensation of muscle, brain and viscera, living or not, is one we no longer know.

And the complex process of imagining it is only the beginning of the deep stretch of the mind these photographs provoke.

Many show medicine at its cocky, callous worst. Some students posed the cadaver as one of the boys — hat on head, pipe in bared grinning teeth, skeletal fist clutching a fan of playing cards. In one 1905 shot a balding, fully clad student lies on the dissection table while six flayed cadavers are propped to a standing position around him, purportedly preparing to cut. The photographer took the trouble to copyright this shot, titled “A Student’s Dream.”

But the other side of medicine is visible here, as well. For a haunting image of all it has ever aspired to be, little can surpass one of the last photographs in the book, shot at an unknown medical school in 1950. Four young men cluster about the head of a table, gazing down at the face of their eviscerated cadaver. The photographer has created the illusion that the body rests, Pietà-like, in their laps; the light illuminates their hair. Forget the truckloads of grandiose prose that has been spun about the art and science of medicine over the centuries: one look at this picture and you understand what it is all supposed to be about.

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